Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092)
Background and Purpose - Loss of motor function is common after stroke and leads to significant chronic disability. Stem cells are capable of self-renewal and of differentiating into multiple cell types, including neurones, glia, and vascular cells. We assessed the safety of granulocyte-colony-stimu...
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| Format: | Article |
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American Heart Association
2006
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| Online Access: | https://eprints.nottingham.ac.uk/508/ |
| _version_ | 1848790422944481280 |
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| author | Sprigg, Nikola Bath, Philip M.W. Zhao, Lian Willmot, Mark Gray, Laura J. Walker, Marion F. Dennis, Martin S. Russell, Nigel |
| author_facet | Sprigg, Nikola Bath, Philip M.W. Zhao, Lian Willmot, Mark Gray, Laura J. Walker, Marion F. Dennis, Martin S. Russell, Nigel |
| author_sort | Sprigg, Nikola |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background and Purpose - Loss of motor function is common after stroke and leads to significant chronic disability. Stem cells are capable of self-renewal and of differentiating into multiple cell types, including neurones, glia, and vascular cells. We assessed the safety of granulocyte-colony-stimulating factor (G-CSF) after stroke and its effect on circulating CD34 stem cells.
Methods - We performed a 2-center, dose-escalation, double-blind, randomized, placebo-controlled pilot trial (ISRCTN 16784092) of G-CSF (6 blocks of 1 to 10 g/kg SC, 1 or 5 daily doses) in 36 patients with recent ischemic stroke. Circulating CD34 stem cells were measured by flow cytometry; blood counts and measures of safety and functional outcome were also monitored. All measures were made blinded to treatment.
Results - Thirty-six patients, whose mean SD age was 768 years and of whom 50% were male, were recruited. G-CSF
(5 days of 10 g/kg) increased CD34 count in a dose-dependent manner, from 2.5 to 37.7 at day 5 (area under curve, P0.005). A dose-dependent rise in white cell count (P0.001) was also seen. There was no difference between
treatment groups in the number of patients with serious adverse events: G-CSF, 7/24 (29%) versus placebo 3/12 (25%),
or in their dependence (modified Rankin Scale, median 4, interquartile range, 3 to 5) at 90 days.
Conclusions - ”G-CSF is effective at mobilizing bone marrow CD34 stem cells in patients with recent ischemic stroke.
Administration is feasible and appears to be safe and well tolerated. The fate of mobilized cells and their effect on
functional outcome remain to be determined. (Stroke. 2006;37:2979-2983.) |
| first_indexed | 2025-11-14T18:12:22Z |
| format | Article |
| id | nottingham-508 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T18:12:22Z |
| publishDate | 2006 |
| publisher | American Heart Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-5082020-05-04T20:30:17Z https://eprints.nottingham.ac.uk/508/ Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) Sprigg, Nikola Bath, Philip M.W. Zhao, Lian Willmot, Mark Gray, Laura J. Walker, Marion F. Dennis, Martin S. Russell, Nigel Background and Purpose - Loss of motor function is common after stroke and leads to significant chronic disability. Stem cells are capable of self-renewal and of differentiating into multiple cell types, including neurones, glia, and vascular cells. We assessed the safety of granulocyte-colony-stimulating factor (G-CSF) after stroke and its effect on circulating CD34 stem cells. Methods - We performed a 2-center, dose-escalation, double-blind, randomized, placebo-controlled pilot trial (ISRCTN 16784092) of G-CSF (6 blocks of 1 to 10 g/kg SC, 1 or 5 daily doses) in 36 patients with recent ischemic stroke. Circulating CD34 stem cells were measured by flow cytometry; blood counts and measures of safety and functional outcome were also monitored. All measures were made blinded to treatment. Results - Thirty-six patients, whose mean SD age was 768 years and of whom 50% were male, were recruited. G-CSF (5 days of 10 g/kg) increased CD34 count in a dose-dependent manner, from 2.5 to 37.7 at day 5 (area under curve, P0.005). A dose-dependent rise in white cell count (P0.001) was also seen. There was no difference between treatment groups in the number of patients with serious adverse events: G-CSF, 7/24 (29%) versus placebo 3/12 (25%), or in their dependence (modified Rankin Scale, median 4, interquartile range, 3 to 5) at 90 days. Conclusions - ”G-CSF is effective at mobilizing bone marrow CD34 stem cells in patients with recent ischemic stroke. Administration is feasible and appears to be safe and well tolerated. The fate of mobilized cells and their effect on functional outcome remain to be determined. (Stroke. 2006;37:2979-2983.) American Heart Association 2006 Article PeerReviewed Sprigg, Nikola, Bath, Philip M.W., Zhao, Lian, Willmot, Mark, Gray, Laura J., Walker, Marion F., Dennis, Martin S. and Russell, Nigel (2006) Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092). Stroke, 37 . pp. 2979-2983. ischemic stroke; stem cells; colony-stimulating factors; stroke recovery |
| spellingShingle | ischemic stroke; stem cells; colony-stimulating factors; stroke recovery Sprigg, Nikola Bath, Philip M.W. Zhao, Lian Willmot, Mark Gray, Laura J. Walker, Marion F. Dennis, Martin S. Russell, Nigel Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) |
| title | Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) |
| title_full | Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) |
| title_fullStr | Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) |
| title_full_unstemmed | Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) |
| title_short | Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092) |
| title_sort | granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the stem cell trial of recovery enhancement after stroke (stems) pilot randomized, controlled trial (isrctn 16784092) |
| topic | ischemic stroke; stem cells; colony-stimulating factors; stroke recovery |
| url | https://eprints.nottingham.ac.uk/508/ |